MLAB 2401: Clinical Chemistry Keri Brophy-Martinez Diseases of Mineral and Bone

Hypercalcemia Blood calcium levels above expected range Causes of: Malignancy Primary Hyperparathyroidism Renal Failure Multiple myeloma

Clinical Symptoms of Hypercalcemia CNS Disorientation Lethargy Confusion Depression GI Constipation Nausea Vomiting Renal Kidney stones Skeletal Increased risk of fractures Cardiovascular Hypertention

Hypocalcemia Blood calcium levels below the expected range Causes of: Hypoparathyroidism Decreased vitamin D Inadequate diet Malabsorption Decreased magnesium Decreased calcium intake

Clinical Symptoms Of Hypocalcemia Neuromuscular irritability Muscle cramps Seizures Tetany Cardiac irregularities

Metabolic Bone Diseases Abnormal mineralization of bone Deficiency of vitamin D Rickets Disease state in growing bone of children & adolescents Failure of mineralization of bone Bony deformities Osteomalacia Adults Inadequate or delayed mineralization of bone Loss of bone mass/ bone tissue Osteoporosis Affects women predominantly Increased risk for fractures, especially hip

Hypermagnesemia Increased magnesium Causes of: Acute/chronic renal failure Decreased excretion Endocrine disorders Antacids Bone cancers Severe dehydration Diabetic acidosis

Clinical Symptoms of Hypermagnesemia Cardiovascular Neuromuscular Hypotension Bradycardia Warm skin Nausea Vomiting Lethargy Decreased reflexes Respiratory depression Hypocalcemia

Hypomagnesemia Decrease in the blood level of magnesium Causes of: Reduced Intake Decreased Absorption Increased excretion- RENAL Increased excretion-ENDOCRINE Increased excretion-DRUG INDUCED

Clinical Symptoms of Hypomagnesemia Cardiovascular Psychiatric Depression Agitation Psychosis Hypertension Arrhythmia Weakness Cramps Tetany

Hyperphosphatemia Elevated levels of phosphate in the blood Caused by: Decreased renal excretion Acute/chronic renal failure Increased intake Oral, rectal, IV administration Increased extracellular load Acidosis, shifting of ions

Clinical Symptoms of Hyperphosphatemia No direct symptoms

Hypophosphatemia Decreased level of blood phosphate Caused by: Increased urinary excretion Altered internal redistribution Decreased intestinal absorption

Clinical Symptoms of Hypophosphatemia Present once phosphorus levels decrease to one-half the lower limit of normal. Weakness Dizziness Respiratory Failure Impairment of cardiac contractility

References Bishop, M., Fody, E., & Schoeff, l. (2010). Clinical Chemistry: Techniques, principles, Correlations. Baltimore: Wolters Kluwer Lippincott Williams & Wilkins. Sunheimer, R., & Graves, L. (2010). Clinical Laboratory Chemistry. Upper Saddle River: Pearson .